Annealing-Modulated Surface Reconstruction for Self-Assembly of High-Density Uniform InAs/GaAs Quantum Dots on Large Wafers Substrate.
In this work, we developed pre-grown annealing to form β2 reconstruction sites among β or α (2 × 4) reconstruction phase to promote nucleation for high-density, size/wafer-uniform, photoluminescence (PL)-optimal InAs quantum dot (QD) growth on a large GaAs wafer. Using this, the QD density reached 580 (860) μm-2 at a room-temperature (T) spectral FWHM of 34 (41) meV at the wafer center (and surrounding) (high-rate low-T growth). The smallest FWHM reached 23.6 (24.9) meV at a density of 190 (260) μm-2 (low-rate high-T). The mediate rate formed uniform QDs in the traditional β phase, at a density of 320 (400) μm-2 and a spectral FWHM of 28 (34) meV, while size-diverse QDs formed in β2 at a spectral FWHM of 92 (68) meV and a density of 370 (440) μm-2. From atomic-force-microscope QD height distribution and T-dependent PL spectroscopy, it is found that compared to the dense QDs grown in β phase (mediate rate, 320 μm-2) with the most large dots (240 μm-2), the dense QDs grown in β2 phase (580 μm-2) show many small dots with inter-dot coupling in favor of unsaturated filling and high injection to large dots for PL. The controllable annealing (T, duration) forms β2 or β2-mixed α or β phase in favor of a wafer-uniform dot island and the faster T change enables optimal T for QD growth.


Dimensionless criteria for estimating oxygen transfer in aeration systems.
The effect of power consumption on oxygen transfer efficiency has been evaluated for both surface and subsurface aeration systems. Two new dimensionless criteria (numbers) have been proposed for this purpose. They are termed the efficiency criterion or T(o) number and the power consumption effect criterion or Av number. The analysis presented in this article is based on data obtained on various full-scale aeration systems, and it shows that for each aerator there is an optimum power consumption at which maximum oxygen transfer efficiency results. The oxygen transfer efficiency has maximum values when the efficiency criterion (T(o) number) reaches an approximately constant value. The results have proven that when there are several aerators with identical diameters and the same rotational velocity but different geometrical shapes, the most efficient one will be (after having reached the maximum transfer efficiency) the one with the highest power consumption. For two aerators varying in diameter but with the same parameter as above (maximum transfer, equal rotational velocity), different efficiencies are obtained, the difference being a function of d(-0.5). The results of investigating subsurface aeration systems show that the efficiency of decreased.


The regulatory role of curcumin on platelet functions.
Curcumin, the main ingredient of Curcuma longa L., has been used as a spice and as a herbal medicine with different therapeutic characteristics for centuries in Asian countries. This phytochemical has been shown to possess beneficial antiplatelet activity that has introduced it as a promising candidate for the treatment of thromboembolism, atherothrombosis, and inflammatory diseases. Platelet dysfunction under different circumstances may lead to cardiovascular disease, and curcumin has been shown to have beneficial effects on platelet dysfunction in several studies. Therefore, this narrative review is aimed to summarize available evidence on the antiplatelet activity of curcumin and related molecular mechanisms for this activity.


Untangling Macropore Formation and Current Facilitation in P2X7.
Macropore formation and current facilitation are intriguing phenomena associated with ATP-gated P2X7 receptors (P2X7). Macropores are large pores formed in the cell membrane that allow the passage of large molecules. The precise mechanisms underlying macropore formation remain poorly understood, but recent evidence suggests two alternative pathways: a direct entry through the P2X7 pore itself, and an indirect pathway triggered by P2X7 activation involving additional proteins, such as TMEM16F channel/scramblase. On the other hand, current facilitation refers to the progressive increase in current amplitude and activation kinetics observed with prolonged or repetitive exposure to ATP. Various mechanisms, including the activation of chloride channels and intrinsic properties of P2X7, have been proposed to explain this phenomenon. In this comprehensive review, we present an in-depth overview of P2X7 current facilitation and macropore formation, highlighting new findings and proposing mechanistic models that may offer fresh insights into these untangled processes.


Left ventricular asynergy in mitral valve diseases. A cineangiographic study.
Mode of left ventricular contraction was studied by cine left ventriculography in 22 cases with mitral valve diseases and 7 control cases. In rheumatic mitral valve diseases, local hypokinesis of the left ventricular wall and poor contraction of the mitral annulus were observed frequently, at various location and to various extent. Transient asynergic motion of local wall was also seen either during systole or during diastole. Local hypokinesis was seen even in normal-sized left ventricles, and was associated with decreased cardiac pump performance, when its localization was extensive. Severe mitral regurgitation of rheumatic nature was always associated with poor contraction of the mitral annulus, although the reverse was not true.


Axonal endoplasmic reticulum is very narrow.
The endoplasmic reticulum (ER) is an interconnected network of tubules and sheets. In most tissues of the body, ER tubules have a diameter of ∼60 nm. Using new methods for serial-section electron microscopy, a distinct class of very narrow, 20- to 30-nm-diameter tubules were found in neurons of both the central and peripheral nervous system. The narrow tubules appear to be the most abundant form of ER in axons, and are also found interspersed in the cell bodies and dendrites. At the site of branch points, there is a small sheet that has a similarly narrow lumen. The narrowness of the ER is likely to be important for the as yet poorly characterized functions of the axonal ER.


Intimate partner violence during pregnancy and associated mental health symptoms among pregnant women in Tanzania: a cross-sectional study.
Violence against pregnant women is a prevalent issue with severe health implications, especially during pregnancy. This study seeks to determine the prevalence of intimate partner violence against women during pregnancy and its associated mental health symptoms. Cross-sectional survey conducted from December 2011 to April 2012. Muhimbili National Hospital antenatal clinic in Dar es Salaam, Tanzania. 1180 pregnant antenatal care patients. Trained interviewers conducted face-to-face standardised interviews with the women in a private room prior to their antenatal care appointment. (PTSD), anxiety and depressive symptoms were assessed through the Conflict Tactics Scale, the John Hopkins Symptom Checklist (25) and the Posttraumatic Diagnostic Scale. The Conflict Tactics Scale, the John Hopkins Symptom Checklist (25) and the Posttraumatic Diagnostic Scale. Of the 1180 women who were interviewed, 27% reported experiencing both physical and sexual intimate partner violence in the index pregnancy, with 18% reporting physical violence and 20% reporting sexual violence. After adjusting for the sociodemographic characteristics of women, women who experienced physical and/or sexual intimate partner violence during pregnancy were significantly more likely to have moderate PTSD (AOR 2.94, 95% CI 1.71-5.06), anxiety (AOR 3.98, 95% CI 2.85-5.57) and depressive (AOR 3.31, 95% CI 2.39-4.593) symptoms than women who did not report physical and/or sexual intimate partner violence during pregnancy. About three out of ten women experienced physical or sexual intimate partner violence during pregnancy by an intimate partner, which was significantly associated with poor mental health symptoms. These rates are alarming, and justify training and education of antenatal care providers to raise awareness.


Standardisation of elemental analytical techniques applied to provenance studies of archaeological ceramics: an inter laboratory calibration study.
Chemical analysis is a well-established procedure for the provenancing of archaeological ceramics. Various analytical techniques are routinely used and large amounts of data have been accumulated so far in data banks. However, in order to exchange results obtained by different laboratories, the respective analytical procedures need to be tested in terms of their inter-comparability. In this study, the schemes of analysis used in four laboratories that are involved in archaeological pottery studies on a routine basis were compared. The techniques investigated were neutron activation analysis (NAA), X-ray fluorescence analysis (XRF), inductively coupled plasma optical emission spectrometry (ICP-OES) and inductively coupled plasma mass spectrometry (ICP-MS). For this comparison series of measurements on different geological standard reference materials (SRM) were carried out and the results were statistically evaluated. An attempt was also made towards the establishment of calibration factors between pairs of analytical setups in order to smooth the systematic differences among the results.


Topical Clonazepam Solution for the Management of Burning Mouth Syndrome: A Retrospective Study.
To evaluate and compare the effectiveness of two concentrations of topical clonazepam solution in improving symptoms of burning mouth syndrome (BMS). A retrospective chart review was conducted of patients diagnosed with BMS and managed with topical clonazepam solution between 2008 and 2015. A 0.5-mg/mL solution was prescribed until 2012, when this was changed to a 0.1 mg/mL solution. Patients were instructed to swish with 5 mL for 5 minutes and spit two to four times daily. The efficacies of the two concentrations were compared using patient-reported outcome measures at the first follow-up, including the reported percentage of improvement in burning symptoms and the change in burning severity from baseline ranked on an 11-point numeric rating scale (NRS). Response to treatment was compared between the two concentrations using Wilcoxon rank sum test. A total of 57 subjects were included, 32 in the 0.1-mg/mL cohort and 25 in the 0.5-mg/mL cohort, and evaluated at a median follow-up of 7 weeks. The median overall percentage improvement was 32.5% in the 0.1-mg/mL cohort and 75% in the 0.5-mg/mL cohort. The median reduction in NRS score was 0.5 points in the 0.1-mg/mL cohort and 6 points in the 0.5-mg/mL cohort. The use of either outcome measure revealed that the response to treatment with the 0.5-mg/mL solution was superior to that of the 0.1 mg/mL solution (P < .01). These findings suggest that a 0.5-mg/mL topical clonazepam solution is effective in the management of BMS. Future randomized clinical trials are warranted.


Gonad morphology of Susan's dwarfgoby Eviota susanae.
The gonad morphology of a dwarfgoby Eviota susanae was described and compared with other species within the genus. Eviota susanae was found to have a persistent integrated ovotestis form of gonad in which both spermatogenic and oogenic tissue were found interspersed throughout the gonad. This is consistent with previously described species of Eviota, suggesting that gonad morphology is conserved across the genus.


A Review of Strategies Associated with Surgical Decompression in Traumatic Spinal Cord Injury.
Traumatic spinal cord injury (TSCI) is frequent. Timely diagnosis and treatment have reduced the mortality, but the long-term recovery of neurologic functions remains ominous. After TSCI, tissue bleeding, edema, and adhesions lead to an increase in the intraspinal pressure, further causing the pathophysiologic processes of ischemia and hypoxia and eventually accelerating the cascade of secondary spinal cord injury. Timely surgery with appropriate decompression strategies can reduce that secondary injury. However, disagreement about the safety and effectiveness of decompression surgery and the timing of surgery still exists. The level and severity of spinal cord injury do have an impact on the timing of surgery; therefore, TSCI subpopulations may benefit from early surgery. Early surgery perhaps has little effect on recovery from complete TSCI but might be of benefit in patients with incomplete injury. Early decompression should be considered in patients with incomplete cervical TSCI. Patient age should not be used as an exclusion criterion for early surgery. The best time point for early surgery is although influenced by the shortest duration to thoroughly examine the patient's condition and stabilize the patient's state. After the patient's condition is fully evaluated, we can perform the surgical modality of emergency myelotomy and decompression. Therefore, a number of conditions should be considered, such as standardized decompression methods, indications and operation timing to ensure the effectiveness and safety of early surgical intervention, and promotion of the functional recovery of residual nerve tissue.


Genomic insights into the rapid emergence and evolution of MDR in Staphylococcus pseudintermedius.
MDR methicillin-resistant Staphylococcus pseudintermedius (MRSP) strains have emerged rapidly as major canine pathogens and present serious treatment issues and concerns to public health due to their, albeit low, zoonotic potential. A further understanding of the genetics of resistance arising from a broadly susceptible background of S. pseudintermedius is needed. We sequenced the genomes of 12 S. pseudintermedius isolates of varied STs and resistance phenotypes. Nine distinct clonal lineages had acquired either staphylococcal cassette chromosome (SCC) mec elements and/or Tn5405-like elements carrying up to five resistance genes [aphA3, sat, aadE, erm(B), dfrG] to generate MRSP, MDR methicillin-susceptible S. pseudintermedius and MDR MRSP populations. The most successful and clinically problematic MDR MRSP clones, ST68 SCCmecV(T) and ST71 SCCmecII-III, have further accumulated mutations in gyrA and grlA conferring resistance to fluoroquinolones. The carriage of additional mobile genetic elements (MGEs) was highly variable, suggesting that horizontal gene transfer is frequent in S. pseudintermedius populations. Importantly, the data suggest that MDR MRSP evolved rapidly by the acquisition of a very limited number of MGEs and mutations, and that the use of many classes of antimicrobials may co-select for the spread and emergence of MDR and XDR strains. Antimicrobial stewardship will need to be comprehensive, encompassing human medicine and veterinary disciplines to successfully preserve antimicrobial efficacy.


A phthalimidation protocol that follows protein defined parameters.
This work outlines the first phthalimidation protocol suitable for protein labeling and performed in aqueous media at room temperature and neutral pH with no catalyst or co-reagent required. The methodology is suitable for a range of amines and its efficiency was determined with chemoselective and site-selective protein labeling.


Distance-based generation of a unicursal random path on a non-grid point set for optical polishing.
In modern ultra-precision polishing, sub-aperture technologies are prone to mid-spatial frequency errors due to identical patterns of a path. A random tool path on a regular point set is widely used to suppress mid-spatial frequency errors. In this study, two non-grid uniform point sets, the Fibonacci and the three-directional, were introduced into optical polishing. To solve the time-consuming problem caused by a large amount of distance calculation, a distance-based weighted random (DBWR) algorithm and a linear programming and connecting (LPC) algorithm were presented. The DBWR algorithm reduces the generation time by strengthening the weight of the neighboring points in a specific direction, while the LPC algorithm adjusts the order and distance of points artificially. Then a random stitching method was proposed for the large-scale point set applying to large-sized optical surfaces, which dramatically reduced the generation time. Finally, experiments validated that the algorithms for non-grid sets can be effectively used for optical surface figuring without introducing an apparent mid-spatial frequency.


Preferential Adsorption of Prominent Amino Acids in the Urease Enzyme of Sporosarcina pasteurii on Arid Soil Components: A Periodic DFT Study.
The urease enzyme is commonly used in microbially induced carbonate precipitation (MICP) and enzyme-induced carbonate precipitation (EICP) to heal and strengthen soil. Improving our understanding of the adsorption of the urease enzyme with various soil surfaces can lead to advancements in the MICP and EICP engineering methods as well as other areas of soil science. In this work, we use density functional theory (DFT) to investigate the urease enzyme's binding ability with four common arid soil components: quartz, corundum, albite, and hematite. As the urease enzyme cannot directly be simulated with DFT due to its size, the amino acids comprising at least 5% of the urease enzyme were simulated instead. An adsorption model incorporating the Gibbs free energy was used to determine the existence of amino acid-mineral binding modes. It was found that the nine simulated amino acids bind preferentially to the different soil components. Alanine favors corundum, glycine and threonine favor hematite, and aspartic acid favors albite. It was found that, under the standard environmental conditions considered here, amino acid binding to quartz is unfavorable. In the polymeric form where the side chains would dominate the binding interactions, hematite favors aspartic acid through its R-OH group and corundum favors glutamic acid through its R-Ket group. Overall, our model predicts that the urease enzyme produced by Sporosarcina pasteurii can bind to various oxides found in arid soil through its alanine, glycine, aspartic/glutamic acid, or threonine residues.


Solitalea lacus sp. nov., isolated from pond sediment.
A Gram-stain-negative, strictly aerobic, oxidase-positive, catalase-negative, motile by gliding, creamy white-pigmented bacterium, designated strain S2-8T, isolated from a sediment sample from a Wiyang pond in the Republic of Korea, was subjected to polyphasic taxonomic analysis. Growth was observed at 10-40 °C (optimum: 30 °C), pH 7-8 and 0-0.5% NaCl. Phylogenetic analyses based on 16S rRNA gene sequences revealed that strain S2-8T belonged to the family Sphingobacteriaceae in the phylum Bacteroidota and was closely related to Solitalea longa HR-AVT, Solitalea canadensis DSM 3403T and Solitalea koreensis R2A36-4T with 97.2, 96.7 and 93.7 % 16S rRNA gene sequence similarities, respectively. Average nucleotide identity and digital DNA-DNA hybridization values for these type strains were 72.0-75.2% and 21.2-21.9 %, respectively. The major respiratory quinone is menaquinone-7. The major fatty acids were iso-C15 : 0, iso-C17 : 0 3-OH and summed feature 3 (comprising C16 : 1 ω7c and/or C16 : 1 ω6c). The major polar lipids were phosphatidylethanolamine, two unidentified amino acids and four unidentified lipids. The G+C content of genomic DNA was 37.9 mol%. Based on polyphasic taxonomic analysis, it was observed that strain S2-8T is a novel species belonging to the genus Solitalea, for which the name Solitalea lacus sp. nov. is proposed. The type strain is S2-8T (= KACC 22266T= JCM 34533T).


Fulminant Acute Kidney Injury in a Young Patient with Novel Coronavirus 2019.
Coronavirus disease 2019 (COVID-19) is a global pandemic affecting more than 200 countries and 180,000 cases in the United States. While the outbreak began in China, the number of cases outside of China exceeded those in China on March 15, 2020 and are currently rising at an exponential rate. The number of fatalities in the United States are expected to exceed more than Italy and China. The disease is characterized predominantly as an acute respiratory illness. However, preliminary data suggests that kidney is a target for the virus and deterioration of renal function was associated with poor outcomes including in-hospital mortality. We pre-sent a report of a patient with COVID-19 who presented with acute onset of symptoms and normal renal function at baseline but rapidly deteriorated resulting in death. The timing of decline in renal function correlated with his worsening clinical status. He was started on continuous veno-venous hemofiltration without signs of clinical benefit. We also present the possible mechanisms for acute kidney injury in these patients. We performed a review of the emerging literature by searching PubMed, Google Scholar, and EMBASE for studies and/or case series published on this topic. Acute kidney injury might help risk stratify critically ill patients on a fatal course of COVID-19.


Prophylactic antiparkinson drug use: I. Initial prophylaxis and prevention of extrapyramidal side effects.
The use of prophylactic antiparkinson medications during neuroleptic treatment is controversial. Although the efficacy of these agents in the treatment of extrapyramidal side effects is well established, the questions of when to initiate therapy and for how long remain unanswered. There are only a few double-blind, placebo-controlled studies on the value of concurrent antiparkinson drug use at the beginning of neuroleptic treatment. The authors reviewed all studies on initial prophylaxis, and found most to be methodologically deficient. There is evidence to support the use of these agents to prevent acute dystonic reactions. Further work needs to focus on other types of extrapyramidal symptoms. In light of the inability to predict who will experience these side effects, the authors conclude that initial prophylaxis is beneficial for most patients who are starting neuroleptic medications.


SOME POPULATION GENETIC CONSEQUENCES OF COLONY FORMATION AND EXTINCTION: GENETIC CORRELATIONS WITHIN FOUNDING GROUPS.
Extinction and recolonization in an island model affects genetic differentiation among subpopulations through a combination of sampling and mixing. We investigate the balance of these forces in a general model of population founding that predicts first the genetic variance among new groups and then the effect of these new groups on the total genetic variance among all populations. We allow for a broad range of types of mixing at the time of colonization and demonstrate the significant effects on differentiation from the probability of common origin of gametes (φ). We further demonstrate that kin-structured founding and inbreeding within populations can have a significant effect on the genetic variance among groups and use these results to make predictions about lineal fission and fusion of populations. These results show that population structure is critically affected by non-equilibrium dynamics and that the properties of new populations, especially founding number, probability of common origin, and kin structure, are vital in our understanding of genetic variation.


Optimizing therapy of seizures in adult patients with psychiatric comorbidity.
This article provides an overview of appropriate antiepileptic treatment in adult patients with chronic epilepsy and concomitant psychiatric disorders. It highlights the influence of various treatment options for epilepsy on psychiatric symptoms. Six specific topics are discussed: psychosocial aspects and treatment compliance; positive and negative psychotropic effects of antiepileptic drugs (AEDs); pharmacokinetic and pharmacodynamic interactions between AEDs and psychoactive drugs; risks and benefits of resective surgery; the effect of vagal nerve stimulation; and recommended strategies for optimizing epilepsy therapy in patients with psychiatric disorders. Given the multitude of epilepsy treatment options with various CNS effects, it is crucial to select treatments according to the clinical profile of each individual patient.


PTEN reverses MDM2-mediated chemotherapy resistance by interacting with p53 in acute lymphoblastic leukemia cells.
The tumor suppressor PTEN has been associated with the cellular localization of MDM2 in regulation of apoptosis through inhibiting PI3k/Akt signaling. To investigate whether expression of PTEN is involved in MDM2-mediated chemoresistance, we examined a set of acute lymphoblastic leukemia (ALL) cell lines for the expression of PTEN and sensitivity to doxorubicin. Testing 9 ALL cell lines selected for wild-type p53 phenotype and uniformly high levels of MDM2 expression, we initially demonstrated that cell lines with high levels of PTEN expression were sensitive to doxorubicin, whereas lines lacking PTEN expression were generally resistant. Forced expression of PTEN in a PTEN-negative and doxorubicin-resistant ALL line (EU-1) resulted in decreased cell growth and enhanced sensitivity to doxorubicin. Examining the cellular localization of MDM2, we confirmed that the majority of MDM2 is localized in the nucleus in PTEN-negative doxorubicin-sensitive ALL cells, whereas MDM2 is expressed predominantly in the cytoplasm in either PTEN-positive or PTEN-transfected cells. Furthermore, by coimmunoprecipitaton and cotransfection assays, we found that PTEN physically binds p53 in vitro as well as in vivo. Binding of PTEN to p53 attenuated MDM2-mediated p53 inhibition. These results suggest that PTEN inhibits MDM2 and protects p53 through both p13k/Akt-dependent and -independent pathways. Furthermore, loss of PTEN can result in resistance to apoptosis by activating MDM2-mediated antiapoptotic mechanism.


QRISK3 relation to carotid plaque is higer than that of score in patients with systemic lupus erythematosus.
SLE has been described as an independent risk factor for the development of cardiovascular (CV) disease. Recently, the QRESEARCH risk estimator version 3 (QRISK3) calculator has been launched for CV risk assessment in the general population. QRISK3 now includes the presence of SLE as one of its variables for calculating CV risk. Our objective was to compare the predictive capacity between QRISK3 and the Systematic Coronary Risk Evaluation (SCORE) for the presence of subclinical carotid atherosclerosis in patients with SLE. Two hundred and ninety-six patients with SLE were recruited. The presence of subclinical atherosclerosis was evaluated by carotid ultrasound to identify carotid plaque and the thickness of the carotid intima-media (cIMT). QRISK3 and SCORE were calculated. The relationship of QRISK3 and SCORE with each other and with the presence of subclinical carotid atherosclerosis (both carotid plaque and cIMT) was studied. There was no correlation between SCORE and QRISK3 in patients with SLE (Spearman's rho = -0.008, P = 0.90). Although QRISK3 showed a statistically significant correlation with cIMT (Spearman's rho = 0.420, P = 0.000), this relationship was not found between SCORE and cIMT (Spearman's rho = -0.005, P = 0.93). The discrimination capacity of QRISK3 for the presence of carotid plaque was statistically significant and superior to that of SCORE (AUC 0.765 [95% CI: 0.711, 0.820] vs 0.561 [95% CI: 0.494, 0.629], P = 0.000). QRISK3 discrimination for subclinical atherosclerosis is higher than that of SCORE. QRISK3, and not SCORE, should be used for the calculation of CV risk in patients with SLE.


The Effects and Meanings of Receiving a Diagnosis of Mild Cognitive Impairment or Alzheimer's Disease When One Lives Alone.
One third of older adults with cognitive impairment live alone and are at high risk for poor health outcomes. Little is known about how older adults who live alone experience the process of receiving a diagnosis of mild cognitive impairment (MCI) or Alzheimer's disease (AD). The aim of this study was to understand the effects and meanings of receiving a diagnosis of MCI or AD on the lived experience of older adults living alone. This is a qualitative study of adults age 65 and over living alone with cognitive impairment. Participants' lived experiences were elicited through ethnographic interviews and participant observation in their homes. Using a qualitative content analysis approach, interview transcripts and fieldnotes were analyzed to identify codes and themes. Twenty-nine older adults and 6 members of their social circles completed 114 ethnographic interviews. Core themes included: relief, distress, ambiguous recollections, and not knowing what to do. Participants sometimes felt uplifted and relieved by the diagnostic process. Some participants did not mention having received a diagnosis or had only partial recollections about it. Participants reported that, as time passed, they did not know what to do with regard to the treatment of their condition. Sometimes they also did not know how to prepare for a likely worsening of their condition, which they would experience while living alone. Findings suggest the need for more tailored care and follow-up as soon as MCI or AD is diagnosed in persons living alone.


Chaotic dynamics from coupled magnetic monodomain and Josephson current.
The ordinary (superconductor-insulator-superconductor) Josephson junction cannot exhibit chaos in the absence of an external ac drive, whereas in the superconductor-ferromagnet-superconductor Josephson junction, known as the φ_{0} junction, the magnetic layer effectively provides two extra degrees of freedom that can facilitate chaotic dynamics in the resulting four-dimensional autonomous system. In this work, we use the Landau-Lifshitz-Gilbert model for the magnetic moment of the ferromagnetic weak link, while the Josephson junction is described by the resistively capacitively shunted-junction model. We study the chaotic dynamics of the system for parameters surrounding the ferromagnetic resonance region, i.e., for which the Josephson frequency is reasonably close to the ferromagnetic frequency. We show that, due to the conservation of magnetic moment magnitude, two of the numerically computed full spectrum Lyapunov characteristic exponents are trivially zero. One-parameter bifurcation diagrams are used to investigate various transitions that occur between quasiperiodic, chaotic, and regular regions as the dc-bias current through the junction, I, is varied. We also compute two-dimensional bifurcation diagrams, which are similar to traditional isospike diagrams, to display the different periodicities and synchronization properties in the I-G parameter space, where G is the ratio between the Josephson energy and the magnetic anisotropy energy. We find that as I is reduced the onset of chaos occurs shortly before the transition to the superconducting state. This onset of chaos is signaled by a rapid rise in supercurrent (I_{S}⟶I) which corresponds, dynamically, to increasing anharmonicity in phase rotations of the junction.


Deep learning-based segmentation and classification of leaf images for detection of tomato plant disease.
Plants contribute significantly to the global food supply. Various Plant diseases can result in production losses, which can be avoided by maintaining vigilance. However, manually monitoring plant diseases by agriculture experts and botanists is time-consuming, challenging and error-prone. To reduce the risk of disease severity, machine vision technology (i.e., artificial intelligence) can play a significant role. In the alternative method, the severity of the disease can be diminished through computer technologies and the cooperation of humans. These methods can also eliminate the disadvantages of manual observation. In this work, we proposed a solution to detect tomato plant disease using a deep leaning-based system utilizing the plant leaves image data. We utilized an architecture for deep learning based on a recently developed convolutional neural network that is trained over 18,161 segmented and non-segmented tomato leaf images-using a supervised learning approach to detect and recognize various tomato diseases using the Inception Net model in the research work. For the detection and segmentation of disease-affected regions, two state-of-the-art semantic segmentation models, i.e., U-Net and Modified U-Net, are utilized in this work. The plant leaf pixels are binary and classified by the model as Region of Interest (ROI) and background. There is also an examination of the presentation of binary arrangement (healthy and diseased leaves), six-level classification (healthy and other ailing leaf groups), and ten-level classification (healthy and other types of ailing leaves) models. The Modified U-net segmentation model outperforms the simple U-net segmentation model by 98.66 percent, 98.5 IoU score, and 98.73 percent on the dice. InceptionNet1 achieves 99.95% accuracy for binary classification problems and 99.12% for classifying six segmented class images; InceptionNet outperformed the Modified U-net model to achieve higher accuracy. The experimental results of our proposed method for classifying plant diseases demonstrate that it outperforms the methods currently available in the literature.


An Appraisal of Opioid Treatment Agreements for the Podiatric Physician.
Opioid treatment agreements are written agreements between physicians and patients that represent strategies enumerating the risks associated with opioid medications. These opioid treatment agreements set expectations and obligations, as well as identify responsibilities for both patient and prescriber for opioid therapy. Some critics assert that these agreements are cumbersome and degrade the patient once they enter into these agreements. A systemic literature search and review using the Preferred Reporting Item for Systematic Reviews and Meta-Analyses (PRISMA) tool was used to find citations describing opioid treatment agreements and their use. Then eligible and appropriate citations were dissected and analyzed. Using the available federal and state opioid prescribing policies, best practice guidelines as well as positive aspects of reviewed literature citations and avoiding bias, degrading, or macroaggression language, a non-cumbersome opioid treatment agreement specific to podiatric medicine was created. A balance argument for the use of opioid treatment agreements to avoid opioid use disorder that is grounded in clinical literature and commentaries are presented. A one-page sensible opioid treatment agreement specific to podiatric medicine, which is similar to more complex cumbersome ones that are found in the literature, and that may be used as part of any podiatric procedural or surgical inform consent, was created and is presented for review. The perception of defending opioid treatment agreements as documents of disclosure to assist patients in their autonomy was offered. Building on the systemic review findings and concept of using elements of disclosure, a model for an analgesic treatment as a one-page informational document to enhance podiatric physicians to create a specific individual analgesic treatment agreement mirroring the scope of podiatric practices that can be incorporated into procedural and surgical inform consent documents was offered.


A Dosimetric Comparison of Primary Chemoradiation Versus Postoperative Radiation for Locally Advanced Oropharyngeal Cancer.
Introduction Advanced-stage oropharyngeal cancer can be treated with primary chemoradiation (CRT) or primary surgery with adjuvant radiotherapy, both with similar survival outcomes. Though primary CRT prescribes a higher dose, adjuvant radiation requires irradiating the surgical bed, which may increase the high dose planned target volume (PTV). We hypothesize that the integral dose to the neck and dose to critical structures will be lower with primary CRT than adjuvant radiotherapy. Methods We selected the last 18 patients who underwent surgery and adjuvant radiotherapy at one institution between July 2015 and August 2016 with American Joint Committee on Cancer (AJCC) stage III or IVA oropharyngeal squamous cell cancer. Primary CRT treatment plans were created on the patients' preoperative computed tomography (CT) scans and prescribed 70 Gy in 33 fractions, while postoperative plans were prescribed 60 Gy in 30 fractions. The radiation doses received by organs at risk for each primary CRT plan were compared to the corresponding adjuvant radiation plan. Results Primary CRT plans had significantly smaller high dose PTV than adjuvant radiation plans (187.3 cc (95% CI 134.9-239.7) and 466.3 cc (95% CI 356.7-575.9), p<0.0001). The neck integral dose was lower in 14 of 18 plans using primary CRT, although this was not statistically significant (p=0.5375). The primary CRT plans had lower mean doses to ipsilateral (31.8 Gy (95% CI 27.5-36.0) vs 39.3 Gy (95% CI 35.4-43.1), p=0.0009)) and contralateral parotid glands (22.5 Gy (95% CI 22.1-22.8) vs 27.6 Gy (95% CI 23.4-31.8), p=0.0238) and larynx (20.7 Gy (95% CI 19.3-22.2) vs 40.2 Gy (95% CI 30.8-46.6), p<0.0001). Conclusion Primary CRT offered a decreased neck integral dose, though it was statistically insignificant. Primary CRT plans reduce mean dose to larynx and parotid glands in comparison to postoperative radiation, which may result in lower toxicities. Clinical trials comparing primary CRT and primary surgery are warranted to compare patient toxicities.


A filarial nematode secreted product differentially modulates expression and activation of protein kinase C isoforms in B lymphocytes.
Filarial nematodes, parasitic worms that cause elephantiasis, chronic skin lesions, and blindness in the tropics, release a number of molecules, some of which appear to be immunomodulatory/suppressive, into the host environment. Here we demonstrate that ES-62, a phosphorylcholine-containing glycoprotein released by the rodent filarial parasite Acanthocheilonema viteae, interferes with activation of B lymphocytes by differential modulation of protein kinase C isoform expression. Indeed, while ES-62 selectively down-regulates expression of the alpha, beta, iota/lambda, delta, and zeta isoforms of PKC, it up-regulates expression of PKC-gamma and -epsilon in B cells. Inhibitor studies suggest that ES-62 appears to promote down-regulation of PKC isoforms mainly by stimulating proteolytic degradation. ES-62 also disrupts the normal activation and nuclear translocation patterns of the alpha and iota/lambda isoforms of PKC following ligation of the Ag receptor. The effects of ES-62 on certain PKC isoforms were found to be modified by coculture with IL-4. Of particular interest was the observation that IL-4 prevented down-regulation of PKC alpha and iota/lambda, isotypes considered to be active in transducing mitogenic signals. Phosphorylcholine-containing secreted products (phosphorylcholine-ES) are also released by human filarial parasites; hence we discuss how these findings may relate to the nature of the human B cell response during filarial infections.


Families with special needs children: family health, functioning, and care burden.
There are 11.2 million children with special health care needs in the United States or one in five households caring for a special needs child. A small group of children who need continuous medical, nursing, therapeutic services that enable them to survive is growing in numbers. This study examined physical health (physical functioning), mental health (emotional, social, and cognitive functioning; communication; and worry), family functioning (daily activities, family relationships), and care burden (caregiver employment, caregiving time, travel time, health-related out-of-pocket expenditures) of parent caregivers for medically complex, medical technology-dependent children. Data were collected once a month for 5 months on 84 parents recruited in South Florida using the Pediatric Quality of Life Family Impact Module. Physically, parents were tired when they woke up: too tired to do the things they liked to do and with little energy for chores or social activities. Mentally, they were frustrated, anxious, and angry; felt helpless and hopeless; had cognitive problems remembering and focusing on tasks; were worried about the child's medications, treatments, side effects; and were anxious about child's future and effect of the child's condition on other family members. Socially, they felt isolated and that people did not understand their family situation; they found it hard to talk with others including physicians and nurses. Average weekly hours of direct care was 33.0 (SD = 30.4 hours); average monthly out-of-pocket expenditures was $348.78 (SD = $623.34). It is essential to assess parents' physical and mental health and functioning and to provide interventions to improve health and functioning for both the parents and the children for whom they are caring.


Suppression of STAT3 Phosphorylation and RelA/p65 Acetylation Mediated by MicroRNA134 Plays a Pivotal Role in the Apoptotic Effect of Lambertianic Acid.
As p300-mediated RelA/p65 hyperacetylation by signal transducers and activators of transcription 3 (STAT3) is critical for NF-κB activation, in the current study, the apoptotic mechanism of lambertianic acid (LA) was explored in relation to STAT3 phosphorylation and RelA/p65 acetylation in MCF-7, DU145, PC-3, and MDA-MB-453 cells. LA significantly increased the cytotoxicity, sub G 1 population, and the cleavage of poly (ADP-ribose) polymerase (PARP) in MDA-MB-453 or PC-3 cells (STAT3 mutant), more than in the MCF-7 or DU145 cells (STAT3 wild). Consistently, LA inhibited the phosphorylation of STAT3 and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), and disrupted the interaction between p-STAT3, p300, NF-κB, and RelA/p65 acetylation (Ac-RelA/p65) in the MCF-7 and DU145 cells. Also, LA reduced the nuclear translocation of STAT3 and NF-κB via their colocalization, and also suppressed the protein expression of XIAP, survivin, Bcl-2, Bcl-xL, vascular endothelial growth factor (VEGF), Cox-2, c-Myc and mRNA expression of interleukin 6 (IL-6), and tumor necrosis factor-α (TNF-α) in MCF-7 cells. Conversely, IL-6 blocked the ability of LA to suppress the cytotoxicity and PARP cleavage, while the depletion of STAT3 or p300 enhanced the PARP cleavage of LA in the MCF-7 cells. Notably, LA upregulated the level of miRNA134 and so miRNA134 mimic attenuated the expression of pro-PARP, p-STAT3, and Ac-RelA, while the miRNA134 inhibitor reversed the ability of LA to reduce the expression of Ac-RelA and pro-PARP in MCF-7 cells. Overall, these findings suggest that LA induced apoptosis via the miRNA-134 mediated inhibition of STAT3 and RelA/p65 acetylation.


Unraveling the roles of endoplasmic reticulum-associated degradation in metabolic disorders.
Misfolded proteins retained in the endoplasmic reticulum cause many human diseases. ER-associated degradation (ERAD) is one of the protein quality and quantity control system located at ER, which is responsible for translocating the misfolded proteins or properly folded but excess proteins out of the ER for proteasomal degradation. Recent studies have revealed that mice with ERAD deficiency in specific cell types exhibit impaired metabolism homeostasis and metabolic diseases. Here, we highlight the ERAD physiological functions in metabolic disorders in a substrate-dependent and cell type-specific manner.


Patients' self-evaluation after 4-12 weeks following xenon or propofol anaesthesia: a comparison.
The aim of this study was to assess postoperative patients' self-evaluation after xenon anaesthesia compared to total intravenous anaesthesia with propofol. 160 patients aged 18-60 yr, ASA I-II undergoing elective surgery took part in this randomised-controlled trial. After approval by the local Ethics Committee and as soon as the patients had given their written informed consent, they were randomly allocated to either the xenon (n = 80) or propofol (n = 80) group. In both groups remifentanil was used as opioid. The postoperative patients' self-evaluation was assessed with a double-blind telephone poll. Early spatial orientation, patients' self-evaluation of anaesthesia, choice of the same anaesthesia for future operations and recall of uncomfortable feelings after anaesthesia were determined. 116 Patients were analysed, 63 in the xenon and 53 in the propofol group. The two study groups were comparable with respect to age, weight, height, gender and ASA classification. The two groups indicated similar values in the early spatial orientation at the onset of recovery and thereafter. Patients' self-evaluation of anaesthesia with main emphasis at high marks and repetition of the same anaesthesia if necessary were similar in both groups. Recalls of uncomfortable feelings were comparable but not for postoperative pain and appetite/thirst which appeared with a significantly higher incidence in the xenon group. Patients' self-evaluation and memory of early spatial orientation following xenon anaesthesia are comparable to propofol.


Social defeat stress causes selective attenuation of neuronal activity in the ventromedial prefrontal cortex.
The ventromedial prefrontal cortex (vmPFC) plays key roles in higher cognitive abilities, including mental representations and the regulation of emotion. Previous studies have reported that vmPFC activity is altered in depressed human patients, highlighting this subregion as a major site of dysfunction in neuropsychiatric diseases. To examine how neuronal activity at spike levels in the vmPFC is altered by social defeat stress, we performed electrophysiological multiunit recordings along the dorsoventral axis of the mPFC of freely moving mice. Chronic social defeat stress-susceptible mice showing an impairment in social interaction exhibited significant reductions in the overall spike frequencies of neurons in the vmPFC, but not in the dorsal mPFC. Analysis of local field potentials revealed that the vmPFC generated spatially constrained 20-40 Hz events lasting hundreds of milliseconds, with an average event frequency of 0.05 Hz; during these events, a subset of neurons were transiently inhibited. The frequency of 20-40 Hz events in the vmPFC was reduced in defeated stress-susceptible animals, and this decrease was reversed by systemic ketamine administration. The novel neurophysiological correlates of stress-induced changes in the vmPFC advance the understanding of the neural basis of stress-induced dysregulation of social behavior.


Evidence that the purinergic receptor P2Y12 potentiates platelet shape change by a Rho kinase-dependent mechanism.
ADP activates human platelets through two G-protein coupled receptors, P2Y1 and P2Y12, to induce a range of functional responses. Here we have addressed the role and mechanism of P2Y12 in modulating ADP-induced platelet shape change. Although the response depended upon activation of P2Y1, it was potentiated by P2Y12 as the P2Y12-selective antagonists AR-C69931MX and 2MeSAMP partially inhibited shape change in the later phase of the response. This was paralleled by inhibition of pseudopod formation, platelet spheration, actin polymerisation and myosin light chain phosphorylation. P2Y12 is known to couple to activation of PI3 kinase and inhibition of adenylate cyclase, but we showed that neither of these signalling events couples to regulation of shape change by this receptor. However, by assessment of phosphorylation of its major substrate myosin light chain phosphatase, we provide direct evidence for activation of Rho kinase by ADP, and that although P2Y1 is required for activation of Rho kinase, P2Y12 is able to potentiate its activity. We conclude that P2Y12 plays a potentiatory role in ADP-induced shape change through regulation of the Rho kinase pathway, potentiating both myosin phosphorylation and actin polymerisation, and this forms part of an important signalling pathway additional to its well-established Gi-coupled pathways.


[Breast volume assessment based on 3D surface geometry: verification of the method using MR imaging].
Differences in breast volume and contour are subjectively estimated by surgeons. 3D surface imaging using 3D scanners provides objective breast volume quantification, but precision and accuracy of the method requires verification. Breast volumes of five test individuals were assessed using a 3D surface scanner. Magnetic resonance imaging (MRI) reference volumes were obtained to verify and compare the 3D scan measurements. The anatomical thorax wall curvature was segmented using MRI data and compared to the interpolated curvature of the posterior breast volume delimitation of 3D scan data. MRI showed higher measurement precision, mean deviation (expressed as percentage of volume) of 1.10+/-0.34% compared to 1.63+/-0.53% for the 3D scanner. Mean MRI [right (left) breasts: 638 (629)+/-143 (138) cc] and 3D scan [right (left) breasts: 493 (497)+/-112 (116) cc] breast volumes significantly correlated [right (left) breasts: r=0.982 (0.977), p=0.003 (0.004)]. The posterior thorax wall of the 3D scan model showed high agreement with the MRI thorax wall curvature [mean positive (negative) deviation: 0.33 (-0.17)+/-0.37 cm]. High correspondence and correlation of 3D scan data with MRI-based verifications support 3D surface imaging as sufficiently precise and accurate for breast volume measurements.


Forensic Entomology in Animal Cruelty Cases.
Forensic entomology can be useful to the veterinary professional in cases of animal cruelty. A main application of forensic entomology is to determine the minimum postmortem interval by estimating the time of insect colonization, based on knowledge of the rate of development of pioneer colonizers and on insect species succession during decomposition of animal remains. Since insect development is temperature dependent, these estimates require documentation of the environmental conditions, including ambient temperature. It can also aid in the detection and recognition of wounds, as well as estimate the timing of periods of neglect. Knowledge of the geographic distribution of insects that colonize animal remains may suggest that there has been movement or concealment of the carcass or can create associations between a suspect, a victim, and a crime scene. In some instances, it can aid in the detection of drugs or toxins within decomposed or skeletonized remains. During animal cruelty investigations, it may become the responsibility of the veterinary professional to document and collect entomological evidence from live animals or during the necropsy. The applications of forensic entomology are discussed. A protocol is described for documenting and collecting entomological evidence at the scene and during the necropsy, with additional emphasis on recording geographic location, meteorological data, and collection and preservation of insect specimens.


Entrainment of the mammalian cell cycle by the circadian clock: modeling two coupled cellular rhythms.
The cell division cycle and the circadian clock represent two major cellular rhythms. These two periodic processes are coupled in multiple ways, given that several molecular components of the cell cycle network are controlled in a circadian manner. For example, in the network of cyclin-dependent kinases (Cdks) that governs progression along the successive phases of the cell cycle, the synthesis of the kinase Wee1, which inhibits the G2/M transition, is enhanced by the complex CLOCK-BMAL1 that plays a central role in the circadian clock network. Another component of the latter network, REV-ERBα, inhibits the synthesis of the Cdk inhibitor p21. Moreover, the synthesis of the oncogene c-Myc, which promotes G1 cyclin synthesis, is repressed by CLOCK-BMAL1. Using detailed computational models for the two networks we investigate the conditions in which the mammalian cell cycle can be entrained by the circadian clock. We show that the cell cycle can be brought to oscillate at a period of 24 h or 48 h when its autonomous period prior to coupling is in an appropriate range. The model indicates that the combination of multiple modes of coupling does not necessarily facilitate entrainment of the cell cycle by the circadian clock. Entrainment can also occur as a result of circadian variations in the level of a growth factor controlling entry into G1. Outside the range of entrainment, the coupling to the circadian clock may lead to disconnected oscillations in the cell cycle and the circadian system, or to complex oscillatory dynamics of the cell cycle in the form of endoreplication, complex periodic oscillations or chaos. The model predicts that the transition from entrainment to 24 h or 48 h might occur when the strength of coupling to the circadian clock or the level of growth factor decrease below critical values.


Curcumin enhances Apo2L/TRAIL-induced apoptosis in chemoresistant ovarian cancer cells.
Curcumin, the active component of turmeric (Curcuma longa), exhibits growth inhibitory activity against prostate, colon, and breast cancer; however, the effect of curcumin on ovarian cancer cells is not known. We hypothesized that curcumin could induce cell death in ovarian cancer cells, and enhance apoptosis induced by tumor necrosis factor-related apoptosis inducing Apo2 ligand/TRAIL. Chemoresistant ovarian cancer cell lines SKOV3 and ES-2 were used. The cytotoxic effect of curcumin, Apo2L/TRAIL, and curcumin+Apo2L/TRAIL in combination was determined by sulforhodamine assay. Apoptotic fraction was determined by staining cells with propidium iodide followed by analysis of the sub-G0 DNA content of cells by flow cytometry. Caspase activation was determined by immunoblotting. Curcumin alone had a cytotoxic effect in cisplatin-resistant cells at 25 microM. Curcumin at low doses (5-15 microM) or Apo2L/TRAIL alone was not significantly cytotoxic to the cell lines tested. Preincubating cells with curcumin at low doses prior to treating with Apo2L/TRAIL resulted in markedly enhanced cell death. The combined treatment of curcumin and Apo2L/TRAIL resulted in activation of both the extrinsic, receptor-mediated apoptotic pathway (cleavage of caspase-8) and the intrinsic, mitochondria-mediated apoptotic pathway (cleavage of caspase-9). Combined curcumin and Apo2L/TRAIL treatment results in enhanced induction of apoptotic cell death. Because curcumin and Apo2L/TRAIL together can activate both the extrinsic and intrinsic pathways of apoptosis, they may circumvent chemoresistance to conventional chemotherapeutic agents.


Brain structural co-development is associated with internalizing symptoms two years later in the ABCD cohort.
About 1/3 of youth spend more than four hours/day engaged in screen media activity (SMA). This investigation utilized longitudinal brain imaging and mediation analyses to examine relationships among SMA, brain patterns, and internalizing problems. Data from Adolescent Brain Cognitive Development (ABCD) participants with baseline and two-year follow-up structural imaging data that passed quality control (N = 5,166; 2,385 girls) were analyzed. Joint and Individual Variation Explained (JIVE) identified a brain co-development pattern among 221 brain features (i.e., differences in surface area, thickness, or cortical and subcortical gray-matter volume between baseline and two-year-follow-up data). Generalized linear mixed-effect models investigated associations between baseline SMA, structural co-development and internalizing and externalizing psychopathology at two-year follow-up. SMA at baseline was related to internalizing psychopathology at year 2 (β=0.020,SE=0.008,P=0.014) and a structural co-development pattern (β=0.015,SE=0.007,P=0.029), where the co-development pattern suggested that rates of change in gray-matter volumes of the brainstem, gray-matter volumes and/or cortical thickness measures of bilateral superior frontal, rostral middle frontal, inferior parietal, and inferior temporal regions were more similar than those in other regions. This component partially mediated the relationship between baseline SMA and future internalizing problems (indirect effect = 0.020, P-value = 0.043, proportion mediated: 2.24%). Greater youth engagement in SMA at ages 9-10 years statistically predicted higher levels of internalizing two years later. This association was mediated by cortical-brainstem circuitry, albeit with relatively small effect sizes. The findings may help delineate processes contributing to internalizing behaviors and assist in identifying individuals at greater risk for such problems.


Effects of Curcuminoids and Surfactant-Formulated Curcumin on Chemo-Resistant Colorectal Cancer.
Colorectal cancer (CRC) is a leading cause of cancer-related death in the United States, and chronic gut inflammation is a risk factor for CRC initiation and development. Curcuma longa L., or turmeric, has become one of the most studied herbal medicines in recent years due to its anticancer potentials. It is generally accepted that the major component in turmeric is curcuminoids, and the active constituent in curcuminoids is curcumin. However, unprocessed curcumin is characterized by poor water solubility, which means low bioavailability in humans. To increase the bioavailability of curcumin, in this study, we utilized a novel surfactant-formulated curcumin (CuminUP60[Formula: see text]) and evaluated its CRC chemopreventive activities. Compared with the chemo-sensitive CRC cell line HCT-116, the management of the CRC SW-480 cell line is a challenge, since the latter is chemo-resistant. In other words, these cancer cells resist the effects of the chemotherapy. Using the newly formulated CuminUP60[Formula: see text] water solution, this study demonstrated its strong antiproliferative effects on the SW-480 cells in a dose- and time-dependent manner. This new formulation induced early apoptosis and arrested the cell cycle in the G2/M phase via the upregulation of cyclin B1. We also observed that this new formulation possessed inhibitory effects on Th17 cell differentiation, which regulates the body's immune response against gut malignancies. In summary, our results exhibited a potential clinical utility of the surfactant-formulated curcumin in chemo-resistant colorectal cancer management.


The hematology of bacterial infections in premature infants.
A series of premature infants was studied for the presence of bacterial infection. On the basis of clinical evidence and bacteriological studies, they were divided into three groups in which sepsis was considered to be proven, possible, or unlikely. Band neutrophil counts were elevated most frequently in the "sepsis-proven" group and the elevation occurred usually within 24 hours of onset of signs of disease. Qualitative changes in neutrophils (Döhle bodies, toxic granulation, and vacuolization) were more frequent in the sepsis-proven group and, together with the band count, provided valuable techniques for the diagnosis of bacterial infections. Thrombocytopenia occurred frequently in the sepsis-proven group and seemed to result from increased utilization or destruction of platelets rather than failure of production. In such cases, evidence of intravascular coagulation was minimal and it was concluded that thrombocytopenia had resulted from a direct effect of the bacteria or its products on platelets and/or endothelium.


Hepatitis E in a region of Italy: An emerging autochthonous infection?
Recent data showed an increasing number of "autochthonous" cases of hepatitis E in Italy. Analysing cases of acute hepatitis E to define frequency, clinical features, prognosis and risk factors. We considered all the patients admitted to our Regional Hospital between August 2011 and September 2014, with a diagnosis of acute hepatitis; serological screening for hepatitis B, C and A viruses was performed; in the event of negative results, sera were tested for cytomegalovirus, Epstein-Barr and hepatitis E viruses. Among 200 patients, 66 were affected by viral infection. IgM anti-HEV was detected in 14 patients with a predominance of males (79%) with a mean age of 55. Genotype 3 of HEV was found in 8 patients. Only one patient died of acute on chronic liver failure; all others evolved favourably towards clinical remission within two months from clinical onset. Thirteen patients had had local exposure to infection and 9 reported the consumption of raw or undercooked locally produced pork. The incidence of HEV in our cohort of patients with acute viral hepatitis is high (about 20% per year). In over 85% an autochthonous exposure to infection could be recognised, with a clear link with food habits.


Increased telocytes involved in the proliferation of vascular smooth muscle cells in rat carotid artery balloon injury.
Telocytes (TCs) are a novel type of interstitial cells that are thought to be involved in tissue regeneration and repair. However, the possible roles of TCs in vascular diseases remain unclear. In this study, we used a rat model of carotid artery balloon injury (CABI) to study the changes and potential roles of vascular TCs after vascular injury. Transmission electron microscopy (TEM) and CD34/vimentin immunolabeling were used to identify and quantify TCs in normal and injured carotid arteries. Quantitative immunofluorescence analysis revealed that, compared with the sham group, the number of TCs in the CABI group increased from 7.2±1.0 to an average of 20.4±1.8 per 1-mm(2) vascular area. The expression level of miR-24 in TCs was three times higher than in vascular smooth muscle cells (VSMCs). The percentage of VSMCs in S phase and G2/M phase increased by approximately 5% when VSMCs were incubated with the supernatant of TCs. The antagomir of miR-24 in TCs reduced the ratio of VSMCs in S phase and G2/M phase. This study illuminates the function of TCs in the proliferation of VSMCs.


Fluorinated N,N'-Diarylureas As Novel Therapeutic Agents Against Cancer Stem Cells.
Colorectal cancer is the second-leading cause of cancer-related mortality in the United States. More than 50% of patients with colorectal cancer will develop local recurrence or distant organ metastasis. Cancer stem cells play a major role in the survival and metastasis of cancer cells. In this study, we examined the effects of novel AMP-activated protein kinase (AMPK) activating compounds on colorectal cancer metastatic and stem cell lines as potential candidates for chemotherapy. We found that activation of AMPK by all fluorinated N,N-diarylureas (FND) compounds at micromolar levels significantly inhibited the cell-cycle progression and subsequent cellular proliferation. In addition, we demonstrated that select FNDs significantly increased apoptosis in colorectal cancer metastatic and cancer stem cells. Therefore, FNDs hold considerable promise in the treatment of metastatic colorectal cancer, through elimination of both regular cancer cells and cancer stem cells. Mol Cancer Ther; 16(5); 831-7. ©2017 AACR.


Cultured epidermal autografts in combination with MEEK Micrografting technique in the treatment of major burn injuries.
The treatment of major burn injuries are a formidable challenge to the burn surgeon. Early aggressive surgery for deep to full thickness burn injuries is vital in the prevention of infection. The ultimate goal in major burn injuries is to prevent the onset of multi-resistant organisms and achieve early wound cover. The field of tissue engineering can help to expedite the healing of these burn wounds. The development of keratinocyte culture delivery system can be used clinically to fasten the healing process and save many lives.


An accessible and versatile deep learning-based sleep stage classifier.
Manual sleep scoring for research purposes and for the diagnosis of sleep disorders is labor-intensive and often varies significantly between scorers, which has motivated many attempts to design automatic sleep stage classifiers. With the recent introduction of large, publicly available hand-scored polysomnographic data, and concomitant advances in machine learning methods to solve complex classification problems with supervised learning, the problem has received new attention, and a number of new classifiers that provide excellent accuracy. Most of these however have non-trivial barriers to use. We introduce the Greifswald Sleep Stage Classifier (GSSC), which is free, open source, and can be relatively easily installed and used on any moderately powered computer. In addition, the GSSC has been trained to perform well on a large variety of electrode set-ups, allowing high performance sleep staging with portable systems. The GSSC can also be readily integrated into brain-computer interfaces for real-time inference. These innovations were achieved while simultaneously reaching a level of accuracy equal to, or exceeding, recent state of the art classifiers and human experts, making the GSSC an excellent choice for researchers in need of reliable, automatic sleep staging.


The glucagon-insulin antagonism in the regulation of cytosolic protein binding to the 3' end of phosphoenolpyruvate carboxykinase mRNA in cultured rat hepatocytes. Possible involvement in the stabilization of the mRNA.
Since protein binding to the 3' end of mRNA is believed to be involved in the control of mRNA stability, the time course of alterations in glucagon-induced phosphoenolpyruvate-carboxykinase-mRNA (PCK) levels, in the absence and presence of insulin, was correlated with the time course of changes in the binding of cytosolic protein from 24-h cultured rat hepatocytes to the 3' end of PCK mRNA. PCK-mRNA levels were monitored by Northern blot analysis and protein binding was analyzed by an electrophoretic mobility-shift assay. In 24-h cultured rat hepatocytes, binding of cytosolic protein to the PCK-mRNA 3' end and PCK-mRNA levels were increased to a transient maximum at 2 h and 2-4 h, respectively, by a 1-nM glucagon treatment, added with a change of medium. 100 nM insulin, added simultaneously with glucagon, reduced the glucagon-induced maximum of protein binding by 80% and the increase of PCK mRNA by about 30%. In controls without hormonal treatment protein binding at 1 h was also increased; this increase was prevented by insulin. 100 nM insulin, added 1 h after glucagon, reversed protein binding to the 3' end of PCK mRNA to nearly initial levels within 1 h and impaired the glucagon-induced increase in PCK-mRNA levels by 30%. The transcriptional inhibitor cordycepin, added 1 h after glucagon, did not prevent the further increase in glucagon-enhanced protein binding nor its reversal by insulin. It did, however, prevent a further significant increase in PCK mRNA. Hormonally regulated protein binding could be localized to the 256 distal bases of the PCK-mRNA 3' end. The proximal 466 bases of the PCK-mRNA 3' end as well as the 1050 bases of the histone-H1(0)-mRNA 3' end and the 1200 bases of the arylsulfatase-A-mRNA 3' end also bound cytosolic protein(s), but this protein binding was not altered by treatment with glucagon or insulin. The 3' end of PCK, arylsulfatase A and H1(0) mRNA exhibited strong binding of cytosolic protein(s) from diverse rat tissues such as heart, liver and lung as well as Fao rat hepatoma cells. Cytosolic protein(s) from spleen showed weak binding and proteins from HeLa and U937 tumor cells did not bind. Protein binding was most prominent with the 3' end of PCK mRNA and cytosolic extracts from liver.(ABSTRACT TRUNCATED AT 400 WORDS)


How good is our diagnostic intuition? Clinician prediction of bacteremia in critically ill children.
Clinical intuition and nonanalytic reasoning play a major role in clinical hypothesis generation; however, clinicians' intuition about whether a critically ill child is bacteremic has not been explored. We endeavored to assess pediatric critical care clinicians' ability to predict bacteremia and to evaluate what affected the accuracy of those predictions. We conducted a retrospective review of clinicians' responses to a sepsis screening tool ("Early Sepsis Detection Tool" or "ESDT") over 6 months. The ESDT was completed during the initial evaluation of a possible sepsis episode. If a culture was ordered, they were asked to predict if the culture would be positive or negative. Culture results were compared to predictions for each episode as well as vital signs and laboratory data from the preceding 24 h. From January to July 2017, 266 ESDTs were completed. Of the 135 blood culture episodes, 15% of cultures were positive. Clinicians correctly predicted patients with bacteremia in 82% of cases, but the positive predictive value was just 28% as there was a tendency to overestimate the presence of bacteremia. The negative predictive value was 96%. The presence of bandemia, thrombocytopenia, and abnormal CRP were associated with increased likelihood of correct positive prediction. Clinicians are accurate in predicting critically ill children whose blood cultures, obtained for symptoms of sepsis, will be negative. Clinicians frequently overestimate the presence of bacteremia. The combination of evidence-based practice guidelines and bedside judgment should be leveraged to optimize diagnosis of bacteremia.


Solar driven CO2 hydrogenation to HCOOH on (TiO2)n (n = 1-6) atomic clusters.
Artificial photosynthesis is a crucial reaction that addresses energy and environmental challenges by converting CO2 into fuels and value-added chemicals. However, efficient catalytic activity using earth-abundant materials can be challenging due to intrinsic limitations. Herein, we explore neutral (TiO2)n (n = 1-6) atomic clusters for CO2 hydrogenation via comprehensive ab initio calculations combined with time-dependent functional theory. Our results show that these (TiO2)n clusters exhibit outstanding thermodynamic stabilities and decent surficial activities for CO2 activation and H2 dissociation, both of which possess kinetic barriers down to 0-0.74 eV. We establish a relationship between the binding strength of *CO2 species and electron characterization for these (TiO2)n clusters. These clusters, which have a wide energy gap between the highest occupied molecular orbital (HOMO) and the lowest unoccpied molecular orbital (LUMO) that allows them to harvest the solar light in the ultraviolet regime, enabling efficient catalysis for driving the catalysis of CO2 conversion. They provide exclusive reaction channels and high selectivity for yielding HCOOH products via the carboxyl mechanism, involving the kinetic barrier of the limiting step of 0.74-1.25 eV. We also investigated the substrate effect on supported (TiO2)n clusters, with non-metallic substrates featuring inert surfaces serving as suitable options for anchoring (TiO2)n clusters while preserving their intrinsic activity and selectivity. These computational results have significant implications not only for meeting energy demands but also for mitigating carbon emissions by utilizing CO2 as an alternative feedstock rather than considering it solely as a greenhouse gas.


Ophthalmic artery Doppler waveform in the newborn.
The ophthalmic artery Doppler waveform (OADW) is thought to correlate with severity of systemic atherosclerosis. The goal of the present study was to evaluate risk of cardiovascular disease (CVD) in newborns small for gestational age (SGA) and appropriate for gestational age (AGA). A total of 15 SGA and 26 AGA newborns were enrolled in the study. OADW was compared between SGA and AGA groups. The median Doppler maximums of both eyes in the SGA group were significantly smaller than in the AGA group (maximum average velocity (max A) 6.4cm/s vs. 8.3cm/s, P=0.028; maximum end diastolic velocity (max D) 2.2cm/s vs. 3.4cm/s, P=0.003). The maximums of both eyes for the maximum resistivity index (max RI) and maximum pulsatility index (max PI) in the SGA group were significantly greater than in the AGA group (RI, 0.88 vs. 0.82, P=0.005; PI, 2.23 vs. 1.72, P=0.002). When a multiple linear regression analysis of the SGA group with a stepwise procedure was applied to positive variables from 2-sided comparisons, significant correlations were noted for max A and max PI (max A: R(2)=0.495, β=0.541, P=0.034; max PI: β=-3.318, P=0.012). OADW in SGA newborns may be related to future risk of CVD, which is undetectable in infancy, and can provide information to estimate future cardiovascular health.


Recent advances in defect-engineered molybdenum sulfides for catalytic applications.
Electrochemical energy conversion and storage driven by renewable energy sources is drawing ever-increasing interest owing to the needs of sustainable development. Progress in the related electrochemical reactions relies on highly active and cost-effective catalysts to accelerate the sluggish kinetics. A substantial number of catalysts have been exploited recently, thanks to the advances in materials science and engineering. In particular, molybdenum sulfide (MoSx) furnishes a classic platform for studying catalytic mechanisms, improving catalytic performance and developing novel catalytic reactions. Herein, the recent theoretical and experimental progress of defective MoSx for catalytic applications is reviewed. This article begins with a brief description of the structure and basic catalytic applications of MoS2. The employment of defective two-dimensional and non-two-dimensional MoSx catalysts in the hydrogen evolution reaction (HER) is then reviewed, with a focus on the combination of theoretical and experimental tools for the rational design of defects and understanding of the reaction mechanisms. Afterward, the applications of defective MoSx as catalysts for the N2 reduction reaction, the CO2 reduction reaction, metal-sulfur batteries, metal-oxygen/air batteries, and the industrial hydrodesulfurization reaction are discussed, with a special emphasis on the synergy of multiple defects in achieving performance breakthroughs. Finally, the perspectives on the challenges and opportunities of defective MoSx for catalysis are presented.


Psychiatric disorders and coronary heart disease in women -- a still neglected topic: review of the literature from 1971 to 2000.
Coronary heart disease (CHD) is the leading cause of death in women aged over 40 years in the United States, for whom it conveys a worse prognosis than for men. Recently, psychosocial factors have been understood to represent significant risk factors for developing CHD, as well as having a worse outcome with established CHD. However, these factors are often overlooked, in particular comorbid psychiatric disorders and psychiatric symptoms. To summarize the current knowledge in this interdisciplinary field, the authors conducted a review of CHD in women, taking into account psychosocial aspects, in particular psychiatric disorders. Medline searches using the keywords 'psychiatric disorder' and 'coronary heart disease' and 'women', and 'psychiatric disorder' and 'cardiac disease' and 'women', were performed, covering the time span from the beginning of the Medline database until January 1, 2001. Quoted items included depression, panic disorder, generalized anxiety disorder, mitral valve prolapse, chest pain, anorexia nervosa, menopause, alcohol abuse, cocaine use, sleep disorder, sexual dysfunction, hostility and type A behavior, as well as other psychosocial aspects. There is accumulating evidence of significant associations between psychosocial factors, in particular psychiatric disorders and psychiatric symptoms, and the development and recurrence of CHD in women. However, in summary, the topic still seems to be neglected. Future research into psychiatric disorders and psychiatric symptoms and CHD in women is strongly required, and the focus on women exclusively is underlined.


[A case of fibrous pseudotumor of the spermatic cord].
A case of fibrous pseudotumor of the left spermatic cord is reported. The patient was a 4-year-old boy with the complaint of swelling and pain of the left scrotal contents. An intrascrotal tumor was suspected and surgical exploration was carried out. A small tumor was resected and histological examination revealed fibrous pseudotumor. This tumor was not a true neoplasm, but was due to an inflammatory disease. The clinical and histological findings of the tumor are discussed.


Case study of a 2022 pertussis epidemic in the Baoro sub-prefecture (Central African Republic).
The objective of this survey was to describe epidemiological characteristics and evaluate vaccine effectiveness against pertussis in the sub-prefecture of Baoro (Central African Republic). We conducted a case control study from June to July 2022 in the sub-prefecture of Baoro in the district of Baour-Baoro. Community-based definitions of surveillance were applied to include cases and controls. All in all, 143 confirmed and suspected cases and 166 controls were enrolled in this investigation. The epidemic had affected 12 neighborhoods and 9 villages. The village of Bugbassem alone had 32 patients, and 50% of the patients lived in rural areas. The age groups of 12 to 59 months accounted for 58% of cases. Patients were female in 54% of cases (p = 0.8). The attack rate among unvaccinated patients (65%) was higher than that of vaccinated patients (40%), while 15% (N = 21) of children were hospitalized with no recorded deaths. Pentavalent 3rd dose vaccination coverage was 49% in controls versus 33% in cases. Vaccination provided a significant protective effect (Odds Ratio = 0.3; 95% CI: 0.2-0.6). All told, vaccine efficacy against pertussis was 38%. Pertussis is a re-emerging disease currently occurring as a result of low pertussis vaccination coverage. It strongly affects rural areas with low vaccination rates. Vaccination strategy requires reinforcement in rural areas.


Prevalence and Predictors of Prediabetes in Adolescents and Young Adults with Turner Syndrome: A Cross-Sectional Study from Eastern India.
Individuals with Turner syndrome (TS) have a high risk for prediabetes/type 2 Diabetes Mellitus (T2DM). There is scarce data regarding risk factors for prediabetes in TS, specially from South Asia. We conducted a cross-sectional study on girls with TS aged 12-30 years who had achieved pubertal stage B3 and above-spontaneously or with oestrogen. Anthropometric measurements and biochemical tests were conducted, and medical records were reviewed for details about pubertal onset and progression, growth hormone (GH) and oestrogen therapy. Out of 129 patients with TS in our database, 99 met the criteria for inclusion, mean age 18.33+/-3.78 years and mean BMI 20.57+/- 3.71 kg/m2. Prevalence of prediabetes was 23.23%. Plasma-glucose measured after 75 g-oral-anhydrous-glucose-load (OGTT-PPG) identified five additional prediabetes cases, who had normal fasting plasma glucose (FPG) or HbA1c%. Compared to those without prediabetes, TS with prediabetes (n = 23) had higher mean body weight, BMI, waist circumference (WC) [42.02+/- 5.83 vs 36.22+/-8.07, 22.77+/-2.78 vs 19.91+/- 3.72, 85.26+/- 3.52 vs 81.08+/- 4.59, pall < 0.03 ], higher median WC-to-height ratio (WHtR) and WC-to-hip ratio (WHR)((0.64 [0.6-0.69] vs 0.59[0.56- 0.66], 0.9[0.84-1.12] vs 0.85[0.75-1.01], pboth < 0.02), and higher LDL-cholesterol, triglycerides, and greater prevalence of hepatosteatosis (47.1% vs 21.1%, P < 0.01). Among GH recipients (n = 36), those with prediabetes had delayed initiation and shorter duration of GH therapy. There were no differences in cardiometabolic parameters or the prevalence of diabetes between different karyotypic variants of TS. BMI, WC and WHR had significant positive correlation with FBG, OGTT-PPG and HbA1c% (pall < 0.004). Delay in oestrogen initiation had a significant correlation with OGTT-PPG (Spearman's-rho = 0.69, P < 0.004). BMI, WHR and pubertal status were independent predictors for prediabetes (OR: 1.27 [1.03-1.57]), 1.18 [1.04-1.34]) and 0.09[0.02-0.38], respectively, pall < 0.02), but karyotype was not. BMI had the highest sensitivity [cut-off: 21.04 kg/m2 (sensitivity: 82.6%, specificity: 62.2%) and WHR had the highest specificity [cut-off: 0.89 (sensitivity: 73.9%, specificity 78.4%)] for predicting prediabetes. Indian girls with TS have a high risk for prediabetes, irrespective of underlying karyotype and should be screened with oral glucose challenge to identify prediabetes. Timely intervention against central obesity and early initiation of GH and oestrogen should be ensured in TS. Late presenting girls should be closely monitored for dysglycaemia before and during treatment with GH and/or oestrogen.


Nonlinear wave propagation in strongly coupled dusty plasmas.
The nonlinear propagation of low-frequency waves in a strongly coupled dusty plasma medium is studied theoretically in the framework of the phenomenological generalized hydrodynamic (GH) model. A set of simplified model nonlinear equations are derived from the original nonlinear integrodifferential form of the GH model by employing an appropriate physical ansatz. Using standard perturbation techniques characteristic evolution equations for finite small amplitude waves are then obtained in various propagation regimes. The influence of viscoelastic properties arising from dust correlation contributions on the nature of nonlinear solutions is discussed. The modulational stability of dust acoustic waves to parallel perturbation is also examined and it is shown that dust compressibility contributions influenced by the Coulomb coupling effects introduce significant modification in the threshold and range of the instability domain.


Catalyst-Loaded Capsules that Spontaneously Inflate and Violently Eject their Core.
We present a design for polymer capsules that exhibit a range of unusual autonomous behaviors when exposed to a chemical fuel. The capsules have a physically gelled core (alginate-Ca2+) loaded with catalytic (silver) particles and a shell composed of a chemically cross-linked gel. In the presence of the fuel (H2O2), a catalytic reaction occurs, which generates oxygen (O2) gas. The gas collects in a zone between the core and the shell, and the resulting gas pressure causes the elastic shell to stretch. This makes the capsule inflate in a process reminiscent of a swelling pufferfish. As the capsule inflates, the polymer chains in the shell continue to stretch until a breaking point is reached, whereupon the shell ruptures. Three rupture modes are documented: gentle, moderate, and violent. The latter involves the gelled core being forcefully ejected out of the shell in a manner similar to the ejection of needles out of nematocysts on jellyfish. The extent and duration of inflation can be tuned by altering the core and shell composition; for example, shells that are more densely cross-linked swell less and rupture faster. Also, instead of a catalytic reaction, capsule inflation can be achieved by combining reactants, one in the capsule and the other in the external solution, that together generate a different gas (e.g., CO2).


Improved estimation of the initial number of susceptible individuals in the general stochastic epidemic model using penalized likelihood.
The initial size of a completely susceptible population in a group of individuals plays a key role in drawing inferences for epidemic models. However, this can be difficult to obtain in practice because, in any population, there might be individuals who may not transmit the disease during the epidemic. This short note describes how to improve the maximum likelihood estimators of the infection rate and the initial number of susceptible individuals and provides their approximate Hessian matrix for the general stochastic epidemic model by using the concept of the penalized likelihood function. The simulations of major epidemics show significant improvements in performance in averages and coverage ratios for the suggested estimator of the initial number in comparison to existing methods. We applied the proposed method to the Abakaliki smallpox data.


Superatomic Three-Center Bond in a Tri-Icosahedral Au36Ag2(SR)18 Cluster: Analogue of 3c-2e Bond in Molecules.
Probing the nature of electronic stability for ligand-protected gold clusters is important in gold chemistry. A thermally stable Au36Ag2(SR)18 nanocluster was synthesized recently. It has a D3h tri-icosahedral [Au30Ag2]12+ core with 20 valence electrons, which does not follow the magic number of gold superatoms. Herein, we propose a superatomic three-center bond to unveil its electronic stability. The [Au30Ag2]12+ core is viewed as a union of three face-fused superatoms, and chemical bonding analysis suggests a three-superatom-center two-electron (3sc-2e) bond for the octet rule of each superatom, which mimics the bonding framework of the D3h O32- molecule. Moreover, a liganded tri-icosahedral [Au27Pt3Ag2]11+ core with 18 valence electrons is predicted, and three 2sc-2e bonds are formed between each of two superatoms to satisfy the octet rule (analogue of D3h O3), indicating the flexibility of superatomic bonding. Such a superatomic three-center bond extends the community of superatomic bonding and gives a new perspective for superatom assembling.


Epidemic of Mucormycosis in COVID-19 Pandemic: A Position Paper.
During the second wave of COVID-19 pandemic, there is a sudden increase in number of cases mucormycosis infection in India. This communication by the Tropical Neurology subsection expert group of the Indian Academy of Neurology (IAN) describes the clinical and diagnostic features, treatment of the disease and gives recommendations about the ways forward.


Measurement of tinnitus in humans.
Little quantitative measurement of tinnitus was possible before the development of the electric audiometer. Since then many ingenious attempts have been made to simulate the phenomenon. Frequency and masking measurements were described first in 1931 by E. M. Josephson and also by R. L. Wegel, and techniques involving loudness balance, free-field matching and taped sound effects have also been used. More accurate measurement of frequency content can be made by means of music synthesizer. A tinnitus measurement protocol should include assessment of: (1) frequency content; (2) loudness; (3) masking characteristics; and (4) objective measurements. Loudness measurements relate to the annoyance caused by the symptom, which depends, too, on the patient's personality and disposition. Masking characteristics also relate to the loudness of tinnitus and give additional guidance about the suitability of making therapy. They are repeatable and easy to perform. Objective measurements, whether performed with a stethoscope or intrameatal microphone, may reveal vascular bruits or cochlear emissions. We must wait to see how representative are the newer objective measurements of the subjective complaint.


Determination of pemoline in plasma, plasma water, mixed saliva, and urine by high-performance liquid chromatography.
A new determination method of pemoline in plasma, plasma water, mixed saliva, and urine using high-performance liquid chromatography was developed. The detection limit of pemoline using 0.2 ml of the sample was 0.02 microgram/ml in plasma, plasma water, saliva, and urine. The recoveries of pemoline added to plasma, saliva, and urine (each 6 micrograms/ml) were more than 98%. The coefficients of variation of within-run and between-run precisions for 5 concentrations of pemoline in plasma were less than 5 and 6%, respectively. The elimination half-lives of pemoline obtained from the plasma concentration-time curves after a single oral administration of pemoline in two subjects were 6.7 and 10.3 h. Mean values of the ratio between saliva and plasma total concentration in two subjects were 0.55 and 0.64, and mean values of plasma protein binding percent were 35.7 and 25.2%, respectively. The saliva concentrations were in proportion to the plasma unbound pemoline concentrations at simultaneous samplings, and the ratios between saliva and plasma unbound concentration were about 0.9 in two subjects. Usefulness of saliva in the estimation of plasma protein-unbound pemoline concentration was noted.


Mechanical failure of 113 uncemented modular revision femoral components.
We evaluated a large database with mechanical failure of a single uncemented modular femoral component, used in revision hip arthroplasty, as the end point and compared them to a control group treated with the same implant. Patient- and implant-specific risk factors for implant failure were analyzed. All cases of a fractured uncemented modular revision femoral component from one manufacturer until April 2017 were identified and the total number of implants sold until April 2017 was used to calculate the fracture rate. The manufacturer provided data on patient demographics, time to failure, and implant details for all notified fractured devices. Patient- and implant-specific risk factors were evaluated using a logistic regression model with multiple imputations and compared to data from a previously published reference group, where no fractures had been observed. The results of a retrieval analysis of the fractured implants, performed by the manufacturer, were available for evaluation. There were 113 recorded cases with fracture at the modular junction, resulting in a calculated fracture rate of 0.30% (113/37,600). The fracture rate of the implant without signs of improper use was 0.11% (41/37,600). In 79% (89/113) of cases with a failed implant, either a lateralized (high offset) neck segment, an extralong head, or the combination of both were used. Logistic regression analysis revealed male sex, high body mass index (BMI), straight component design, and small neck segments were significant risk factors for failure. Investigation of the implants (76/113) showed at least one sign of improper use in 72 cases. Implant failure at the modular junction is associated with patient- and implant-specific risk factors as well as technical errors during implantation. Whenever possible, the use of short and lateralized neck segments should be avoided with this revision system. Implantation instructions and contraindications need to be adhered to and respected. Cite this article: Bone Joint J 2020;102-B(5):573-579.


Spatial Distribution, Chemical Fraction and Fuzzy Comprehensive Risk Assessment of Heavy Metals in Surface Sediments from the Honghu Lake, China.
Spatial concentrations and chemical fractions of heavy metals (Cr, Cu, Pb, Zn and Cd) in 16 sampling sites from the Honghu Lake were investigated using an atomic absorption spectrophotometer and optimized BCR (the European Community Bureau of Reference) three-stage extraction procedure. Compared with the corresponding probable effect levels (PELs), adverse biological effects of the studied five sediment metals decreased in the sequence of Cr > Cu > Zn > Pb > Cd. Geo-accumulation index (Igeo) values for Cr, Cu, Pb and Zn in each sampling site were at un-contamination level, while the values for Cd varied from un-contamination level to moderate contamination level. Spatially, the enrichment degree of Cd in lower part of the South Lake, the west part of the North Lake and the outlet were higher than the other parts of Honghu Lake. For metal chemical fractions, the proportions of the acid-extractable fraction of five metal contents were in the descending order: Cd, Cu, Zn, Pb and Cr. Cd had the highest bioaccessibility. Being the above indexes focused always on heavy metals' total content or chemical fraction in deterministic assessment system, which may confuse decision makers, the fuzzy comprehensive risk assessment method was established based on PEI (Potential ecological risk index), RAC (Risk assessment code) and fuzzy theory. Average comprehensive risks of heavy metals in sediments revealed the following orders: Cd (considerable risk) > Cu (moderate risk) > Zn (low risk) > Pb > Cr. Thus, Cd and Cu were determined as the pollutants of most concern. The central part of South Honghu Lake (S4, S5, S6, S9, S12 and S14), east part of the North Honghu Lake (S1) and outlet of outlet of the Honghu Lake (S10) were recommended as the priority control areas. Specifically, it is necessary to pay more attention to S1, S4, S5, S6, S9 and S16 when decision making for their calculated membership values (probabilities) of adjacent risk levels quite close.


Food Anthocyanins: Malvidin and Its Glycosides as Promising Antioxidant and Anti-Inflammatory Agents with Potential Health Benefits.
Anthocyanins are flavonoid compounds that are abundantly present in fruits and vegetables. These compounds contribute to the color of these foods and offer various health benefits to consumers due to their biological properties. There are more than 1000 types of anthocyanins in nature, all derived from 27 anthocyanidin aglycones that have different glycosylations and acylations. Malvidin is one of the most well-known anthocyanidins. Several studies, including those conducted on cell lines, animals, and humans, have suggested that malvidin and its glycosides possess anti-carcinogenic, diabetes-control, cardiovascular-disease-prevention, and brain-function-improvement properties. These health benefits are primarily attributed to their antioxidant and anti-inflammatory effects, which are influenced by the molecular mechanisms related to the expression and modulation of critical genes. In this article, we review the available information on the biological activity of malvidin and its glycosides concerning their health-promoting effects.


[A successful case of two-staged operation for Stanford type B acute dissecting aneurysm complicated with total occlusion of the distal abdominal aorta].
A successful case of two-staged operation for Stanford type B acute dissecting aneurysm complicated with total occlusion of the distal abdominal aorta was reported. A 62-year-old male patient with a long history of systemic hypertension developed acute severe chest, back and bilateral legs pain. An enhanced CT demonstrated Stanford type B dissecting aneurysm with occlusion of the left renal artery and bilateral common iliac arteries. On the day of admission, an emergent right axillo-femoral bypass operation using 8 mm ringed EPTFE graft was undertaken to rescue the ischemic legs. The patient's postoperative course was complicated with acute renal failure and paralytic ileus, which were treated with medical treatment. Four months later, the second operation was done for the localized residual dissecting aneurysm in the proximal descending thoracic aorta. The aneurysm was excised, and the entry was closed with Dacron patch using the previously placed axillo-femoral bypass as a technique for preventing distal ischemia. He was recovered uneventfully and was discharged in a good condition.


The effect of different levels of sunflower head pith addition on the properties of model system emulsions prepared from fresh and frozen beef.
The effect of sunflower head pith on the functional properties of emulsions was studied by using a model system. Oil/water (O/W) model emulsion systems were prepared from fresh and frozen beef by the addition of the pith at five concentrations. Emulsion capacity (EC), stability (ES), viscosity (EV), colour and flow properties of the prepared model system emulsions were analyzed. The pith addition increased the EC and ES and the highest EC and ES values were reached when 5% of pith added; however, further increase in the pith concentration caused an inverse trend in these values. Fresh beef emulsions had higher EC and ES values than did frozen beef emulsions. One percent pith concentration was the critic level for the EV values of fresh beef emulsions. EV values of the emulsions reached a maximum level at 5% pith level, followed by a decrease at 7% pit level.


Persistent hydrocephalus after early surgical management of posterior fossa tumors in children: is routine preoperative endoscopic third ventriculostomy justified?
The authors evaluate the incidence of persistent hydrocephalus after early surgical management of pediatric posterior fossa tumors and the indicators for routine preoperative endoscopic third ventriculostomy (ETV). Between 1989 and 2004, 160 children with a posterior fossa tumor were treated at Erasme Hospital in Brussels, Belgium. Hydrocephalus was present at admission in 114 of the patients. Thirty-one patients had severe hydrocephalus (Evans index [EI] > 0.4). Twenty-four of these and the 83 patients with mild hydrocephalus (EI between 0.3 and 0.4) were treated with early posterior fossa surgery (Group 1; 107 patients). In this group, 93 patients underwent a total or subtotal tumor resection associated with external ventricular drainage (Group 1A), and 14 underwent a stereotactic biopsy associated with an ETV (Group 1B). The 53 remaining patients underwent elective posterior fossa surgery (Group 2). Early tumor resection (Group 1A) resolved hydrocephalus in 85 (91%) of 93 patients, whereas an ETV resolved intracranial hypertension in 11 patients (Group 1B). In Group 1, persistent hydrocephalus affected 11 (10%) of 107 patients, seven of whom had symptoms and were treated (three with shunts and four with ETVs). Persistent hydrocephalus was more frequent in children with severe preoperative hydrocephalus (p = 0.002) and with medulloblastomas (p = 0.0154). A total of 22 technically successful ETV procedures were performed. The ETV success rate for controlling hydrocephalus was 81% (18 of 22) and the rate of severe complications was 9% (two of 22). An ETV is an efficient procedure for controlling hydrocephalus associated with posterior fossa tumor. The authors confirm that a routine postoperative ETV is indicated for treating persistent hydrocephalus. For preventing it, however, they recommend early posterior fossa surgery whenever possible. The low rate of persistent hydrocephalus does not justify adopting routine preoperative ETVs.